Results:

The propensity score-matched sample included 3,067 patients in each group; hospice versus usual care. Mean age was 82 years; 53 % were female, and 15% were Black, Asian, or Hispanic. There were no differences between the two groups in patient characteristics, symptom burden, or functional status. In the 6 months after the second discharge, the hospice group had fewer emergency department visits (2.64 vs. 2.82; p = 0.04), intensive-care unit stays (1.25 vs. 1.51; p < 0.001), fewer number days in the hospital (3.90 vs. 4.67; p < 0.0001) and skilled nursing facility (6.44 vs. 4.38; p = 0.04); they were less likely to die in the hospital (3% vs. 56%; p < 0.001). There were no differences in patient stays within 30 days. The authors noted that there was no predictor of who enrolled in hospice versus receiving usual care. The disenrollment rate was 6.7% during the 6-month study period, with a majority occurring within 7 days after enrolling. Any enrollment in hospice had longer median survival (80 vs. 71 days; log-rank test p = 0.004).